A mathematical model for developing hepatitis E virus infection in human population

Abstract

Hepatitis E is an acute viral infectious disease transmitted by fecal-oral route mainly through fecally contaminated drinking water, with cyclic outbreaks and frequent development of acute hepatic encephalopathy in pregnant women. Hepatitis E epidemic outbreaks occur in Central Asia, Africa and Latin America, whereasChina,India,Turkmenistan,Kazakhstan,Tajikistan,Uzbekistan,Kyrgyzstan,Bolivia,Mexico, andTaiwanrepresent endemic geographic regions. Hepatitis E in the structure of acute viral hepatitis morbidity during outbreaks ranges from 64.7% to 80%, whereas sporadic morbidity may be up to 10 to 18.8%. In contrast, percentage of hepatitis E in acute viral hepatitis varies from 0.5% to 12.6% in European countries and some territories of theRussian Federation. The latent active virus circulation was confirmed in various regions of theRussian Federation. All introduced cases were related to recent traveling to the regions with high incidence of hepatitis E, which course clinically did not differ from standard hepatitis E infection, but no cases of infection were recorded after exposure. Lack of contact transmission in this case was associated with low virus survival in environment. Patients with any clinical form including anicteric serve as a source of infection. An increased risk of hepatitis E infection is typical for livestock workers dealing with pigs, employe es of meat processing plants engaged in primary meat carcass processing and working at slaughterhouse. According to the World Health Organization, 20 million cases of hepatitis E virus infection are recorded annually, among which 3 million cases account for acute hepatitis E and related 70 000 lethal outcomes. Chronic liver disorders comprising up to 70% followed by death of pregnant women (40%) as well as acute liver and kidney failure reaching as low as 4% result in lethal outcome in hepatitis E patients. Creating a mathematical model for development of hepatitis E infection could allow to predict changes in its morbidity rate at controlled area. Here, for the first time we propose a mathematical model for developing hepatitis E in human population based on disease course, which may potentially predict an incidence rate for the most dangerous icteric hepatitis E as well as assess amount of individuals susceptible to it at morbidity rise in the geographic region.